7 - Assessment of emotional functioning in persons with pain  pp. 94-113

Assessment of emotional functioning in persons with pain

By Robert D. Kerns and Renata Okonkwo

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The measurement of emotional functioning as an important dimension of the experience of chronic pain has not yet been generally adopted in the field. This observation is puzzling given the large and ever expanding empirical literature on the relationship between the experience of pain and negative mood, symptoms of affective distress, and frank psychiatric disorder. For example, Turk, despite noting the high prevalence of psychiatric disorder, particularly depression, among patients referred to multidisciplinary pain clinics, failed to list the assessment of mood or symptoms of affective distress as one of the commonly cited criteria for evaluating outcomes from these programs. In a more recent review, Turk also failed to identify emotional distress as a key index of clinical effectiveness of chronic pain treatment. A casual review of the published research in the past several years fails to identify the inclusion of measures of emotional distress in most studies of pain treatment outcome, other than those designed to evaluate the efficacy of psychological interventions.

The primary goal of this chapter is to encourage the routine inclusion of specific measures of emotional functioning in the conduct of comprehensive pain assessments in both clinical and research settings, and to provide specific recommendations for the selection of appropriate measures of emotional functioning. This chapter will begin with the presentation of a rationale for the importance of assessing emotional functioning in this context. Specific dimensions of the broader experience of affective distress will be highlighted, particularly the experiences of depression, anxiety, and anger.

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